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Published on: December 3, 2017
[Diagnosis of Periprosthetic Joint Infection of Shoulder Arthroplasties]
Bernd Fink1,2, Florian Sevelda1,3
1Klinik für Endoprothetik, Allgemeine und Rheumaorthopädie, Orthopädische Klinik Markgröningen.
Abstract:
Periprosthetic joint infection of shoulder arthroplasties is one of the most frequent reasons for pain and revision surgery of shoulder arthroplasties. Propionibacterium acnes is one of the commonest microorganisms causing periprosthetic joint infection in shoulder arthroplasties. It is difficult to detect this slow growing microorganism. This paper gives an overview of the different diagnostic methods. A combination of unspecific and specific tests (detection of microorganism and sensitivity to antibiotics) is helpful in identifying a periprosthetic shoulder infection. Aspiration of the joint can combine different unspecific and specific tests. In patients with punctio sicca and suspected periprosthetic joint infection, we recommend biopsy of periprosthetic tissue.
Insights
Diagnosing periprosthetic shoulder infections caused by Propionibacterium acnes requires specific methods. Combining tests like joint aspiration or tissue biopsy improves detection of this challenging microorganism.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Periprosthetic joint infection (PJI) is a significant complication following shoulder arthroplasty.
- Propionibacterium acnes is a common pathogen in shoulder PJI, notoriously difficult to detect due to its slow growth.
- Accurate diagnosis is crucial for effective treatment and preventing revision surgery.
Purpose of the Study:
- To provide an overview of diagnostic methods for periprosthetic shoulder infection.
- To highlight the challenges in detecting Propionibacterium acnes.
- To recommend optimal diagnostic strategies.
Main Methods:
- Review of current diagnostic techniques for periprosthetic shoulder infection.
- Discussion of both unspecific and specific laboratory tests.
- Evaluation of joint aspiration and periprosthetic tissue biopsy.
Main Results:
- Detection of slow-growing microorganisms like Propionibacterium acnes presents diagnostic challenges.
- A combination of unspecific and specific tests enhances diagnostic accuracy.
- Joint aspiration can integrate multiple diagnostic tests effectively.
Conclusions:
- Effective diagnosis of periprosthetic shoulder infection relies on a multi-faceted approach.
- For suspected cases with negative initial aspiration (punctio sicca), periprosthetic tissue biopsy is recommended.
- Timely and accurate diagnosis is key to successful management of shoulder PJI.
